Download - BD EpiCenter™- Integrating Technology
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BD EpiCenter™- Integrating Technology
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History
October 2000
• Launch of BD EpiCenter
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What did we achieve so far?
• Amount of installations– More than 600 EpiCenter installations in Europe
• Connected instruments– Almost 1000 instruments are connected
• Connections to LIS companies– EpiCenter is connected to more than 50 different LIS systems
• Software releases– Approx. two software releases per year including new features
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What is BD EpiCenter ?
– Microbiology Data Management Software designed to
• Improve the microbiology testing process
• Enhance microbiology result quality
• Conduct statistical / epidemiological analysis
– BD EpiCenter Software can be directly interfaced to
• BD BACTEC™
• BD MGIT™
• BD Phoenix ™
• BD INNOVA ™
• Bruker Biotyper™
• and the LIS system
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InformaticsMaldi-Tof BACTEC Phoenix MGIT Manual LIS
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Microbiology Challenges
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Enhance Workflow
Physician/Patient need for rapid microbiology
Control Costs: Staff & Patient management
Availability of skilled
microbiologists
Changing microbiology and
greater complexity• Expertized Results
• Customizable Expert Rules
• Reporting & Epidemiology
Analyze Communicate
• Proactive Alerts• Alert Distribution
• Multi-User Access
• LIS Reporting
EpiCenter
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• How can EpiCenter help you?
– Monitor BD instrument platforms in real time, from any location in or outside the institution
– Anywhere, anytime access to Instrument Status, Test Status, Test Details, Patient History.
– Reduces bottlenecks with access and data entry from multiple locations across the laboratory.
– EpiCenter provides a single interface to Laboratory Information Systems (LIS) for all instruments
Monitor & Integrate
Clin
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Lab
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– Comprehensive Reporting across Patient, Specimen and Test data
– Patient Test History
– Integrate data from multiple platforms and manual tests (E-Test, Kirby-Bauer) to a single microbiology-focused database
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FX Multiple Workgroup* Integration
EpiServer
Room A
EpiClient #1
Room B
EpiClient #2
Room CWorkgroup #1 Workgroup #2*
Hospital Local Area Network (LAN)
Workgroup #3*
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EpiCenter Integration
Hospital Network Lab Information System (LIS)
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EpiCenter IntegrationMALDI-TOF ID from positive BD BACTEC™ blood cultures in minutes, using the Bruker Sepsityper™ kit.MALDI Biotyper ID
automatically integrated into EpiCenter database
Organisms from MALDI ID can be linked to BD Phoenix™ susceptibilities…
… and traced back to the source, a positive BD BACTEC™ bottle
InformaticsMaldi-Tof BACTEC Phoenix MGIT Manual LIS
Inte
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Microbiology Challenges
Mo
nit
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Enhance Workflow
Physician/Patient need for rapid microbiology
Control Costs: Staff & Patient management
Availability of skilled
microbiologists
Changing microbiology and
greater complexity• Expertized Results
• Customizable Expert Rules
• Reporting & Epidemiology
Analyze Communicate
• Proactive Alerts• Alert Distribution
• Multi-User Access
• LIS Reporting
EpiCenter
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Analyze & Communicate
– Improved Quality of Results• Automatically analyze test result data in context of patient and specimen attributes
– Provide Quality Assurance and Result Consistency • Implement lab-specific quality assurance protocols using advanced customizable expert rules
– Deliver Meaningful Information in a Timely Manner for faster Clinical Decision Making• Communicate results directly to LIS systems• Message distribution of alert messages to the correct person or location, using hospital network and e-mail
– Flexible custom reports allow sophisticated epidemiological analysis of microbiology data
Clin
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Lab
Effi
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cy• How can EpiCenter help you?
– Optimize Technician Result Review• Supporting a paperless workflow
– Ready to use reports for MALDI, Phoenix and BACTEC systems• Workflow reports, Surveillance reports, Epidemiology Reports, Performance Reports
– Expert systems for automated result evaluation & correction– Proactive Alert Generation from user-defined criteria
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Workflow Efficiency
• How can EpiCenter help you?
• Workflow optimization in pre-analytical activities, test automation and post analytical investigations.
• Front End support for Laboratory Workflow– Remote Instrument Management– Technician Efficiency– Automated Communication– Reporting Tools
• Back End support for Managers– Better Data Analysis and Faster Reporting – Provides data to address performance improvements– Serve internal customers better
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Epicenter – LIS interface
• Fully Bi-directional Interface
– Using ASTM protocols
• Real time communication
• Customisable uploads and downloads
– You decide what and when
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Epicenter – LIS interface
• Download from the LIS to the EpiCenter system:
– Patient and specimen demographic records
– Isolate information
– Test orders (and results)
– LIS can also download request for specific information to Epicenter that would cause EpiCenter to upload the requested information.
• Upload from the EpiCenter to the LIS:
– Test results (both manual and instrumented tests)
– Isolate information
– Demographic records
– Epicenter can also upload requests for specific information to the LIS that would cause the LIS to download the requested information.
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The Value of BD EpiCenter™ Data Management
• Monitor and Integrate– Seamless Integration of MALDI Biotyper, Phoenix & BACTEC results
• Analyze and Communicate– Leverage EUCAST and Lab-Specific Expert System– Automated Quality Assurance– Automated Result Review support– Automated alerts directed to responsible HCP
• Workflow Automation– Front end support for more efficient sample processing– Improved Sample Integrity – Rapid ID and Automated Critical Alerts to speed up intervention– Back end Data Analysis Flexibility (e.g. Real-time Antibiogram)
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EpiCenter Modules• EpiCenter RTU (ready to use)
– stand alone or interfaces BD instruments to the LIS system– Expert System including interpretation rule and recommendations from EUCAST, CLSI and SFM– Predefined report menu
• EpiCenter PLUS– Additional ability to create custom reports using tools included in the system– Store and report additional data from other test methods– Epidemiology and Surveillance filter package
• EpiCARE– Open expert system allowing creation of customized rules– Automated alerting reporting and modification of results provided by the PHX system
• Multi-User– Ability to deploy EC on multiple computers using the existing facility network
• Sentinel– Enables lab to send alerts to clinicians using EC workstations or via e-mails, mobile phones,…
• Barcode Label Printing– Offers the opportunity to print barcode labels for BD or non-BD consumables
• TB eXiST– 2nd line drugs AST testing for Mycobacteria
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BD EpiCenterTM – EpiCARE Module
Clinical Application Rule Editor• advanced EpiCenter module
• allows to build customized rules
• based on isolate results
• „IF ... THEN ... ELSE“ structure
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Message Distribution Module “Sentinel”• only with EpiCARE module
• to send system messages (alerts) to specific
EpiCenter workstations in-/outside the lab
• different sound files can be configured
• send alert email to specific persons (via defined rule)
• ... may be sent to multiple email addresses
• generate reports on a specific printer on the LAN
BD EpiCenterTM – BD Sentinel Module
server
clientclient
EpiCenter
Hospital LAN
@
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BACTEC Room
Lab Network (TCP/IP)
TB Lab
EpiCenter Server
Lab ManagerBlood Culture/Varia Lab
EpiCenter Client
Gram stain /Rapid ID
BD EpiCenterTM … Helps to Speed Up Your Sepsis Time-To-Report
EpiCenter Client
EpiCenter Client
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Video 1 Video 2
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Communicate Automated Alerts
Hospital Network
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BD EpiCenterTM – Solutions for the Customer Needs
ID/AST
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New ID / AST OfferWhat• Full ID/AST solution integrating BD Phoenix™ and Bruker microflex™
via BD EpiCenter™, optionally using the BD Phoenix AP™. • Six Sigma and Lean approach.• Full EUCAST compliance.
How• Co-Marketing agreement between BD and Bruker Daltonics.• Direct instrument interface between BD EpiCenter™ and the Bruker
MALDI Biotyper software.• Full integration of MALDI ID and BD Phoenix™ AST into the BD
EpiCenter™ BDXpert™ system.• The Bruker Biotyper, BD Phoenix™ and BD BACTEC™ integration via
BD EpiCenter™ provides the most complete state-of-the-art systemfor all microbiology laboratories.
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European Committee on Antibiotic Susceptibility Testing • organized by ESCMID and european national breakpoint committees
• agreed on a model for harmonizing breakpoints in Europe
• wt MIC‘s accessible via internet for specific drug / bug combinations
• based on European data collection
www.eucast.orgwww.eucast.org
BD EpiCenterTM – EUCAST
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Implementation of EUCAST standard in the BD Phoenix™ / BD Epicenter™ System
• Monitoring of EUCAST committee activities initiated as of 2005
• Release of first set of EUCAST compliant panels in Nov 2008
• Release of complete EUCAST standard breakpoints and rules April 2009
• Current software incorporates April 2010 EUCAST update
• BD is committed to release yearly updates of all the standards included in the BDXpert System (EUCAST, CLSI, SFM)
• Current portfolio of EUCAST compliant panels includes 14 Gram-negative and 7 Gram-positive panels.
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Evaluations of Phoenix/Epicenter SystemEvaluations of Phoenix/Epicenter System®®ECCMID 2009, Helsinki
• EUCAST breakpoints in automated susceptibility testing of Gram-positive bacteria -BD PhoenixTM validated.R. Smyth, S. Bengtsson, G. Kahlmeter, G. Babini, E. Montrucchio
• EUCAST breakpoints in automated susceptibility testing of Gram-negative bacteria -BD PhoenixTM validated. R. Smyth, S. Bengtsson, G. Kahlmeter, G. Babini, E. Montrucchio
ECCMID 2010, Vienna:– Evaluation of performances of the Phoenix automated system in the
antimicrobial susceptibility testing using EUCAST breakpoints (Abstr. 2590). T. Giani, V. Conte, M.M. D'Andrea, G.M. Rossolini* (Siena, IT)
– Assessment of the Phoenix system and EUCAST breakpoints for antimicrobial susceptibility testing against contemporary isolates expressing relevant resistance mechanisms (Abstr. 1680).M.I. Morosini, M. García-Castillo*, R. Cantón (Madrid, ES)
– Implementation of EUCAST rules in the Phoenix/Epicenter System®Prof. R.Leclercq, Microbiology, University-Hospital Caen, France (presented at the BD booth)
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BD Phoenix AP™
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Barcode Printing• print accession barcodes for lab consumables
• automatic or manual printout
• routing by Specimen Type / Patient Name
• batch printout
• accession no., patient name, patient ID,
specimen type, test name, isolate no
• barcode on the specimen lab report
• printer and paper can be ordered via BD
BD EpiCenterTM – Barcode Printing Module
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BD Phoenix™ AST 136 Panel
• Full 136 wells dedicated to AST only.• Strong combination with MALDI ID.• Phoenix AP ready to prepare the
inoculum for the AST 136 panels.• Completing the BD Phoenix™ panel
offer: ID/AST, AST 85, AST 136
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Workflow ID / AST• The BD EpiCenter™ will enhance the Biotyper workflow, integrate
Organism ID with BD Phoenix™ antimicrobial susceptibility results and speed-up result review and reporting.
BD and Bruker Daltonics Co-Marketing Advantages
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Direct ID from Pos Blood Cultures• Organisms from positive BD BACTEC™ bottles Identified by the
MALDI-TOF Bruker microflex™ can be linked to BD Phoenix™susceptibility results and interpreted by the BDXpert™ system.
BD and Bruker Daltonics Co-Marketing Advantages
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BACTEC FX
Direct ID
MALDI
EpiCenter
Phoenix
Direct ASTOptionally viaPhoenix AP
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• MALDI for ID
• Phoenix for AST
• Integrated Informatics via BD EpiCenter™
ID/AST Offer Overview
Benefit:– Faster Time to Result
– Direct ID from pos Blood Culture
– Lab Efficiency and Economy
– Huge database (>2000 taxa)
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Sample Workflow – Process Overview
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MALDI Biotyper ID Results on EpiCenter• MALDI ID results automatically transferred to EpiCenter
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MALDI Biotyper ID Results on EpiCenter …Details
• Top 10 MALDI ID results displayed read-only on EpiCenter “Test” tab.
• Top 1 MALDI ID above the Biotyper Probability Threshold automatically reported as EpiCenter “MALDI Biotyper ID” result.
• If no ID is “+” or better then the organism ID is “Unspecified”.• MALDI Quality indicators reported according to Biotyper thresholds.
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MALDI Biotyper ID Results …Consistency Check
• If more than one ID is “+” or better, Biotyper evaluates the consistency:
• Consistency A or B yield the top 1 organism.• Consistency C will yield an “Unspecified” organism.
A: Species Consistency B: Genus Consistency C: No Consistency
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AST Results
• Phoenix AST automatically merged to the isolate result in EpiCenter.
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BD EpiCenterTM – Solutions for the Customer Needs
TB eXiST
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BD EpiCenterTM – TB eXiSTeXtended individual drug Susceptibility Testing• Extended time to test (MGIT AST 4-13 days, TB eXiST up to 56 days)
• Extended testing after Growth Control flagged positive
• Flexible 2nd line drug choice
• Up to 9 concentrations per drug
• Launched in Europe 2008
TBeX_GC
TBeX_3_RA_ 10.0
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BD EpiCenterTM – TB eXiST Plot
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BD Blood Volume Monitoring Tool (BVM)
• The implementation of an automated blood volume tracking process is a way to retain in compliance with existing accreditation guidelines while also improving effectiveness in detecting bacteria in blood.
• The EpiCenter BVM Module is designed for use with BD BACTEC FX™instruments to provide the Customer calculated information on how much blood was drawn prior to incubation of the BACTEC blood culture bottles.
• EpiCenter will provide four predefined Blood Volume Statistical Reports.
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– Data Sheet of means with total number of bottles grouped by Hospital Service, Client ID, Collected by, Specimen type, body site or ungrouped.
BVM Sample Report – Blood Volume Summary
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– Box Plot of Blood Volume by Ward.
BVM Sample Report – Box Plot
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– Plot of mean data over time with a 95% confidence interval.
BVM Sample Report – Blood Volume Plot of Means
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BVM Sample Report – Graphical Count of Bottles and Volume– Number of bottles collected at each blood volume grouped
by Hospital Service, Client ID, Collected By, or ungrouped.
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Questions ?